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Superselective arterial embolization for hemoptysis Clinical Research


On the choice of treatment of acute leukemia. Research object and methods 1 1.1 The self-study admitted to hospital from 1995 to 2001, age ≥ 6O years old a total of 61 cases of acute leukemia patients, average age 65 years (60 to 77 years), 43 males and 18 females male to female ratio was 2.4:1. Them. Acute non-lymphocytic leukemia (AN11) 49 cases of acute lymphoblastic leukemia (A1l) 12 cases. AN11 patients in 49 cases. M5 cases, M24 cases, M,[link widoczny dla zalogowanych], 4 例, M13 cases, M3 cases. All patients in the 12 cases, 1.1 cases, l3 cases, l8 cases. 61 patients,[link widoczny dla zalogowanych], the myelodysplastic syndrome (MDs) into 6 cases, secondary to radiotherapy and chemotherapy in 3 cases, acute and chronic myelogenous granulite 3 cases of acute lymphoblastic CML variable in 1 case. 1.2 The diagnosis and treatment of standard diagnostic and classification criteria in accordance with the FAB criteria. Efficacy of the standard uniform standards in accordance with the domestic Ⅲ. Means of early death in patients with untreated or dissatisfaction with a course of treatment (7d) that died. Induction of death refers to the first two patients who died during induction chemotherapy treatment. 1.3 The use of induction therapy program AN11 DA (daunorubicin, cytarabine) or HA (homoharringtonine base, cytarabine) program. A11 by VDCP (vincristine, daunorubicin, cyclophosphamide, prednisone) program. Dose chemotherapy regimens in accordance with the different subjects were divided into: conventional dose group of 33 cases. Reduction of 28 cases. Conventional dose of daunorubicin (DNR) ≥ 40mg / d, homoharringtonine base (H) ≥ 4mg / d, cytarabine (Ara-C) ≥ 150mg / d; reduction group DNR20mg / d, H2mg or 3mg / d, Ara-c100mg / d. 1.4 statistical reduction of conventional dose group and complete remission rate and the induction of mortality were compared by chi square test. 2 results of conventional dose group were 33 patients, average age 64 years (60 ~ 75 years) after two courses of chemotherapy, complete remission (CR) 10 (30.3), partial remission (PR) 4 (12.1 ), no remission (NR) 7 cases (21.2). 2 cases of early death (6.1). 1O cases of death induced by chemotherapy (3O.3), of which 3 cases of intracranial hemorrhage, 『1 and Unit: flj Chaohu 238000, China Department of Hematology, the First People's Hospital, 4 cases of severe infection, multiple organ failure in 3 cases. Reduction group were 28 patients,[link widoczny dla zalogowanych], average age 66 years (60 ~ 77 years), two courses of chemotherapy after the CR8 (28.6). PR5 cases (17.9). NR6 cases (21.4), 2 cases of early death (7.1). Chemotherapy-induced deaths in 7 patients (25.0), which intracranial hemorrhage in 2 cases, 3 cases of severe infection, multiple organ failure in 2 cases. The chi-square test, the conventional dose group and the reduction rate of complete remission induction period there was no significant difference in mortality (P> 0.05). 3 to discuss the treatment of elderly patients with acute leukemia has been a very difficult problem. Because elderly patients with leukemia are often associated with other underlying diseases, and with age the main function of organ function and decreased bone marrow, so the low tolerance to chemotherapy; with adult acute leukemia patients compared to elderly patients with acute leukemia treatment-related leukemia and increased by the proportion of MDs into; In addition, cytogenetic abnormalities in elderly patients and more common primary drug resistance]. Over a variety of factors-r remission chemotherapy in patients with acute low, early mortality is high,[link widoczny dla zalogowanych], a poor prognosis. For the treatment of elderly patients with acute leukemia has not yet taken the best solution to reach a unified opinion. In recent years with advances in supportive care measures, some scholars have advocated in elderly patients with adult acute leukemia patients with similar strong combination chemotherapy, but other scholars have advocated a more relaxed use of chemotherapy to reduce the early mortality reduction. This study of different doses of chemotherapeutic drugs according to the study were divided into groups and reduction of conventional dose group, results showed that: conventional dose group and complete remission rate of reduction is basically the same, 30.3 and 28.6, respectively, the difference was not significant; conventional dose group induced reduction of mortality rate higher than the group. 30.3 and 25.0, respectively, but no significant differences. Induced increase of mortality may be related to severe suppression of bone marrow after intensive chemotherapy cause serious infection and bleeding. Thus, in elderly patients with acute leukemia should not be asking too much intensity of chemotherapy, patients with specific conditions should be selected according to individual treatment. Good physical condition should be used in elderly patients with conventional dose chemotherapy; generally poor patients should be reduction of chemotherapy,[link widoczny dla zalogowanych], patients can not tolerate chemotherapy to avoid toxicity, died of chemotherapy complications.
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